Will A Social Security Award
Help My Disability Insurance Claim?

Will being approved for Social Security Disability Insurance help your disability insurance claim?  Not necessarily, as the case of Bakos v. Unum[1] shows.  The case also highlights the importance of timeliness in filing.

Bakos was initially awarded disability benefits in December 2014, but Unum later told her she no longer met the Plan’s disability definition as of April 14, 2015.  Bakos appealed the decision and Unum upheld its termination on June 27, 2016.

Bakos also filed for Social Security Disability (SSDI) and, after an appeals process, was awarded full benefits on March 2, 2020.  Bakos then requested that Unum re-open the denial of her claim.  Unum declined to do so and Bakos filed suit.  However, Unum challenged the suit as being time-barred because her Plan had a three-year limitation period, which required Bakos to initiate an action challenging the denial on or before that date (in this case August 6, 2018).

The Court ultimately found for Unum, even though Bakos argued that she had never been notified of the three-year statute of limitations.  In part, the Court found that Bakos had not been diligent in investigating issues relevant to her claim, for example by requesting a copy of her Plan.

The Court also concluded even though Bakos believed her SSDI appeal decision vital to her appeal, she “points to no contractual provision showing why her SSDI result would have any material bearing on the timeliness of her Plan appeal.”

In the end, even though Bakos had an argument that she was disabled because of her SSDI award, Unum found a way to ignore this favorable finding.  The case illustrates how insurance companies will look for any means possible to deny a claim, regardless of whether there is bona fide evidence of disability.  An experienced disability insurance attorney can help navigate important requirements that may arise when a claim has been denied.

If you claim has been denied and you are wondering about next steps, please feel free to reach out to one of our attorneys directly.

[1] Bakos v. Unum Life Ins. Co., CV 121-058, 2022 WL 791922 (S.D. Ga. March 14, 2022).

Every claim is unique and the discussion above is only a limited summary of the court’s ruling in this case. If you are concerned that your insurer is using any of the tactics above to evaluate your claim, an experienced disability insurance attorney can help you assess the situation and determine what options, if any, are available.

 

Search Our Site